anxiety disorders

Question 1

models of stress

Answer 1

biomechanical ‘engineering’

medicophysiological

psychological (transactional)

Question 2

models of stress: psychological (transactional)

Answer 2

interactive
an individuals reaction to stress will depend on a balance between their cognitive processing of percieved threat and percieved ability to cope

coping: problem focussed, emotion focussed

Question 3

models of stress: biomechanical ‘engineering’

Answer 3

someone’s environment disturbed in some way which places a strain on them
strain can be tolerated up to certain extent but if this is exceeded then psychological and pscyhological damage can occur

Question 4

models of stress: medicophysiological

Answer 4

general, non-specific reaction to demand of any nature producing fight or flight response

3 stages of physiological activity: alarm reaction, physiological adaption to stressor, exhaustion/burn out

Question 5

coping with stressed: problem focussed

Answer 5

efforts are directed towards modifying stressor to reduce/eliminate it

e.g. studying for exam

Question 6

coping with stress: emotion focussed

Answer 6

attempt to reduce negative emotions assoc with stress - mental defence mechnanisms

e.g. taking breaks whilst studying to take mind off it

Question 7

fight or flight response and symptoms of anxiety: symptom groups

Answer 7

psychological arousal 
autonomic arousal 
muscle tension 
hyperventilation 
sleep disturbance

Question 8

reactions to stress producing anxiety: psychological arousal

Answer 8

fearful anticipation 
irritability 
sensitivity to noise 
poor concentration 
worrying thoughts

Question 9

reactions to stress producing anxiety: autonomic arousal

Answer 9

GIT: dry mouth, swallowing difficulties, nausea, diarrhoea

resp: tight chest

CVS: palpitations, chest pain

gen-urinary: frequency/urgency, amenorrhoea/dysmenorrea, ED

CNS: dizziness, sweating

Question 10

reactions to stress producing anxiety: muscle tension

Answer 10

tremor
headache
muscle pain

Question 11

reactions to stress producing anxiety: hyperventilation

Answer 11

causing co2 deficit, hypocapnia
numbing tingling in extremeties
breathelssness

Question 12

reactions to stress producing anxiety: sleep disturbance

Answer 12

initial insomnia
frequent waking
nightmares and night terrors

Question 13

generalised anxiety disorder

Answer 13

persistent (several months) symptoms not confined to a situation or object

all symptoms mentioned earlier can occur: psychological arousal, autonomic arousal, muscle tension, hyperventilation, sleep disturbance

Question 14

aetiology GAD

Answer 14

no clear line between normal anxiety and anxiety disorder

stressor acting on a personality predisposed to the disorder by a combination of genetic factors and environmental influences in childhood

Question 15

phobia vs GAD

Answer 15

phobia: symtpoms in specific circumstance

GAD: generalised and persistent anxiety, not restricted to specific event

Question 16

management GAD

Answer 16

counselling: clear plan management, explanation + education, advice re caffeine, alcohol, exercise

relaxation training: group/individual, DVD, tapes, clinician led

medication: sedatives have high risk dependency, antidepressant SSRI or TCA

CBT

Question 17

key features of phobic anxiety disorders

Answer 17

some core features as GAD only in specific circumstances
person behaves to avoid there circumstances - phobic avoidance

sufferer also experiences anxiety if there is a perceived threat of encountering the feared object or situation ‘anticipatory anxiety’

Question 18

3 key phobic anxiety disorders

Answer 18

specific phobias
social phobia
agoraphobia

Question 19

specific phobias ex

Answer 19

spiders
heights
germs 
dentist
blood

Question 20

social phobia

Answer 20

inappropriate anxiety in situation where person feels observed or could be criticised

fear of scrutiny by other people, leading to avoidance of social situations, assoc with low self esteem, fear of critisism

symptoms any of anxiety cluster, partic blushing and hand tremor

Question 21

management social phobia

Answer 21

CBT
education and advice
medication SRRI antidepressants

Question 22

obsessive compulsive disorder

Answer 22

experience recurrent obsessional thoughts and/or compulsive acts

Question 23

obsessional thoughts

Answer 23

ideas, images, impulses
occurring repeatedly, not willed
unpleasant and distressing
recognised as individual’s own thoughts even tho involuntary

usual key anxiety symptoms arise due to distress of thoughts/attempting to resits

Question 24

OCD: compulsive acts or rituals

Answer 24

stereotypical behaviours repeated again and again
not enjoyable
not helpful - not useful
often viewed by sufferer as: preventing some harm to self or others or pointless and resisted with key anxiety symptoms

Question 25

OCD: etiological theory

Answer 25

genetic e.g. gene coding for 5HT receptors

5 HT function abnormalities

Question 26

management OCD

Answer 26

education

serotonergic drugs: SSRI, clomipramine

CBT

psychosurgery

Question 27

post-traumatic stress disorder

Answer 27

delayed and/or protracted reaction to a stressor of exceptional severity (would distress anyone)

• combat
• natural/human-caused disorder
• rape
• assault
• torture
• witnessing any of above

Question 28

PTSD: 3 key elements to reaction

Answer 28

hyperarousal
re-experiencing phenomena
avoidance of reminders

Question 29

PTSD: hyperarousal

Answer 29

persistent anxiety
irritability
insomnia
poor concentration

Question 30

PTSD: re-experiencing phenomena

Answer 30

intense intrusive images

• flashbacks when awake
• nightmares during sleep

Question 31

PTSD: avoidance

Answer 31

emotional numbness
cue avoidance
recall difficulties
diminishes interest

Question 32

aetiology of PTSD: vulnerability factors

Answer 32

• mood disorder
• prev trauma esp as kid
• lack social support
• female

Question 33

aetiology of PTSD: protective factors

Answer 33

higher education and social group

good paternal relationship

Question 34

management PTSD

Answer 34

mild symptoms: watchful waiting, review further month

trauma-focussed CBT if more severe symptoms

eye movement desensitisation and reprocessing

risk dependence with nay sedatives but patient may prefer medication SSRI or TCA